A successful colon cancer treatment plan should include education, nutrition and appropriate medication.

If colon cancer is suspected during the screening colonoscopy, your doctor will perform a biopsy on the suspect tissue and send it to a pathologist, says John R.T. Monson, M.D., a surgical oncologist with the James P. Wilmot Cancer Center at the University of Rochester Medical Center (URMC) and chief of URMC’s division of colorectal surgery in New York.

If cancer is present, you may need one or more tests, including a CT scan (computerized tomography), MRI (magnetic resonance imaging), a chest X-ray and/or special ultrasound to determine the stage of the cancer and whether it’s spread to nearby tissues or other parts of your body, he says.

StagingThe stages of colon cancer vary depending on the size and location of the tumor and whether the cancer is non-invasive (it hasn’t spread) or invasive (it has spread), says Jeffrey F. Griffin, M.D., a colorectal surgeon at East Jefferson General Hospital in Metairie, La.

Stage 0 (Carcinoma in situ): The cancer is confined to the innermost lining of the colon or rectum. “You have cancer cells but they haven’t spread into another kind of tissue,” Griffin says. Monson says: “Stage 0 cancer is 99% curable.”

Stage 1: The cancer has grown into the inner wall of the colon or rectum, but isn’t through the wall. “The cure rate for stage 1 is higher than 90%,” Monson says.

Stage 2: The cancer has grown through the wall of the colon or rectum and has invaded nearby tissue but has not spread to the lymph nodes. “The cure rate for stage 2 colon cancer is about 75%,” he says.

Stage 4: Cancer has spread to other parts of the body, usually the liver or lungs. “The cure rate for stage 4 colon cancer is less than 10%,” he says.

Surgery “For about 75% of patients with colon cancer, the first line of treatment is surgery,” Monson says. “In the majority of cases, we can remove the cancerous segment and reconnect it to healthy parts of the colon or rectum,” he says.

The most common types of surgery are:

Colonoscopy: Not only is colonoscopy a screening tool, this outpatient procedure is also a way to remove small, early-stage polyps from your colon or upper rectum using a colonoscope.

Transanal excision of rectal cancer: “Some small tumors in the lower rectum that are less than 2 centimeters and not advanced cancer can be removed through your anus,” says Tracy L. Hull, M.D., professor of surgery at the Cleveland Clinic and a colorectal surgeon at the Digestive Disease Institute at the Cleveland Clinic.

Laparoscopy (minimally invasive surgery): This surgery is performed through several tiny incisions in your abdominal wall, Hull says. Small instruments with attached cameras are inserted and display images of your colon on a video monitor. Cancerous polyps are removed and nearby lymph nodes may also be removed, she says.

Colectomy (invasive surgery or open surgery): This procedure may be used if the cancer has grown into or through your colon, or can’t be viewed through laparoscopy, Hull says. A large cut is made in your abdominal wall and a portion of the diseased colon is removed. Nearby lymph nodes may also be removed, she says.

Colostomy: As Monson describes the procedure, the surgeon creates an opening (stoma) in your abdominal wall, connects the upper end of your intestine to the stoma and closes the other end. A flat colostomy bag is set over the stoma to collect waste and is kept in position by a special adhesive. In most cases, a stoma is temporary and left in place for several months to allow your colon to heal from the surgery before it’s reconnected to healthy parts of your colon or rectum. If you had a tumor in your lower rectum, you may need to wear a colostomy bag for the rest of your life, he says.

“Most women are usually hospitalized from 3-7 days after colon surgery and take about 6 weeks to recover,” Hull says.

“You should be up and walking the first day after surgery, which can help decrease your need for pain medications and help maintain muscle strength. It’s also important to eat several small nutritious meals throughout the day to maintain health and promote healing,” she says.

“Most women can recover at home and don’t need any kind of rehab unless they have complications like Parkinson’s disease or they’re very elderly,” Hull says.

ChemotherapyIf your colon cancer has spread beyond the wall of the colon or to your lymph nodes, chemotherapy may be recommended as a colon cancer treatment, Monson says.

“Roughly 50% of colon cancer patients undergo a 4-month course of chemotherapy about 4 weeks after surgery,” he says. “Most patients tolerate it very well and rarely lose their hair.”

Radiation “Most patients with colon cancer in the rectum receive radiation, a procedure in which a small beam of radiation targets the area of surgery to reduce the risk of local recurrence,” says Jeffery Long, M.D., a radiation oncologist with Mary Bird Perkins Cancer Center at Terrebonne General Medical Center in Houma, La.

“Generally, patients get 28 daily treatments (Monday through Friday) to treat the rectum and areas where the cancer might have spread,” Long says.

“Radiation isn’t usually given to patients with colon cancer in the large intestine because there’s a very low risk of local recurrence,” he adds.

After radiation, the risk of local recurrence is 5% for early-stage colon cancers and 20% or more for higher stages, Long says.

“Side effects are minimal and may include skin reactions around the anus and/or mild tiredness,” he says.

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